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Pseudomyxoma peritonei treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: results from a single centre

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Abstract

Background

Pseudomyxoma peritonei (PMP) is a rare, slowly progressive disease whose prognosis depends primarily on the completeness of cytoreduction. The value of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and of additional factors predicting long-term outcome and disease-free survival (DFS) remains poorly understood. This study aims to analyse survival rates and prognostic factors in patients undergoing maximal cytoreduction and HIPEC.

Methods

Thirty patients were selected from a prospective database of records for patients undergoing cytoreduction and HIPEC with mitomycin C or paclitaxel. Overall survival (OS), DFS, and the prognostic factors influencing them, were examined using multivariate analysis.

Results

Median follow-up was 44 months (range, 8–144). Histological classification of PMPs was DPAM in 6/30 of cases, PMCA-I in 10/30 and PMCA in 14/30. Complete cytoreduction (CC-0 and CC-1) was achieved in 28/30 of patients and CC-2 in 2/30. Median OS was 111 months (range 0–230) and five-year OS rate was 67%. Median DFS was 53.5 months (range 0–120) and 5-year DFS rate was 44%. Incomplete cytoreduction, lymph node involvement and PCI>20 were associated with poor prognosis for OS, while lymph node involvement, elevated CA-125 levels, unfavourable histology and previous chemotherapy were associated with poor outcomes for DFS. There was morbidity of Grade 3 or higher in 9/30. Post-operative mortality occurred in 1 case.

Conclusion

Cytoreduction plus peritonectomy procedures combined with HIPEC is a safe treatment and could improve survival rates. Since the optimal cytoreduction is the primary prognostic factor, patients should be centralised under the care of experienced teams.

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Authors and Affiliations

  1. Department of General Surgery, Unit of Surgical Oncology Hospital Universitario Reina Sofía, Avda. Menéndez Pidal, s/n, ES-14004, Córdoba, Spain

    Álvaro Arjona-Sánchez, Francisco C. Muñoz-Casares, Sebastián Rufián-Peña, Rafael Díaz-Nieto & Ángela Casado-Adam

  2. Department of Oncology, Hospital Universitario Reina Sofía, Córdoba, Spain

    María J. Rubio-Pérez

  3. Department of Pathology, Hospital Universitario Reina Sofía, Córdoba, Spain

    Rosa Ortega-Salas

Authors
  1. Álvaro Arjona-Sánchez
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  2. Francisco C. Muñoz-Casares
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  3. Sebastián Rufián-Peña
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  4. Rafael Díaz-Nieto
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  5. Ángela Casado-Adam
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  6. María J. Rubio-Pérez
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  7. Rosa Ortega-Salas
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Correspondence to Álvaro Arjona-Sánchez.

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Arjona-Sánchez, Á., Muñoz-Casares, F.C., Rufián-Peña, S. et al. Pseudomyxoma peritonei treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: results from a single centre. Clin Transl Oncol 13, 261–267 (2011). https://doi.org/10.1007/s12094-011-0651-8

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  • DOI: https://doi.org/10.1007/s12094-011-0651-8

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